1. JAUNDICE UNIV VAN PTA Pretoria Academic Hospital GASTROENTEROLOGY
Dr Obedy Mwantembe
24/11/2018

2. JAUNDICE
Symptom
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3. Three Causes
Prehepatic
Hepatic
Post Hepatic
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4. HISTORY Duration and onset Drug intake/history The Progression
Associated Features
Pruritus
Colour of stool
Anaemia
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5. PHYSICAL EXAMINATION Confirm Jaundice Xanthelasma Scratch Marks
Masses – Liver/Spleen
Gall Bladder
Murphy’s Sign
Courvoisier’s Law
Courvoisier’s Sign
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6. LABORATORY Biochemistry SEROLOGY ALP GGT Anti smooth muscle antibodies
Total IgG
Anti-mitochondria antibodies
Total IgM
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7. GASTROENTEROLOGIST
SONAR
MRCP
ERCP
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8. SONAR Available Cost effective Not invasive
Observer/ operator dependent
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9. SONAR Masses Fluids / Mixed fluids OBSTRUCTION Dilated Ducts
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10. MRCP
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11. ERCP Endoscopic Retrograde Cholangio-pancreatography Diagnostic
Therapeutic
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12. ERCP Sphincterotomy Stone Extraction Stenting Cyst Drainage FBC/INR
Obstructive jaundice
Pancreatitis
Cyst Drainage
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13. DRAINAGE
After attempted Stenting
PTC
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14. PERCUTANEOUS
Percutaneous Transhepatic Cholangiography
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15. WELCOME TO THE DEPARTMENT
EVERY DAY
Mornings
24/11/2018